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Submitted: 17 Feb 2018
Accepted: 04 Jul 2018
ePublished: 28 Jul 2018
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J Renal Inj Prev. 2019;8(2): 78-81.
doi: 10.15171/jrip.2019.15

Scopus ID: 85063809943
  Abstract View: 4371
  PDF Download: 2300

Original

Prevalence and antibiotic resistance pattern of extended spectrum beta lactamase producing Escherichia coli isolated from urinary tract infection

Mohsen Rajabnia 1, Mohammad Saad Forghani 2, Sabah Hasani 3, Mohammad Bahadoram 4, Mahsa Mohammadi 1, Maedeh Barahman 5*

1 Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
2 Department of Internal Medicine, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
3 Lung Diseases and Allergy Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
4 Medical Student Research Committee & Social Determinant of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
5 Department of Radiation Oncology, Firoozgar Hospital, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences (IUMS), Tehran, Iran
*Corresponding Author: *Corresponding author: Maedeh Barahman, Email: maedeh.barahman@gmail.com, , Email: brahman.m@iums.ac.ir

Abstract

Introduction: Urinary tract infection (UTI) due to extended spectrum beta-lactamase (ESBL)-producing bacteria including Escherichia coli has become widespread. Studies have shown a trend toward higher mortality, longer hospitalization, greater hospital expenses and reduced rates of clinical and microbiologic response in ESBL UTI.

Objectives: The aim of this study is to determinate the prevalence and antibiotic resistance pattern of ESBL producing E. coli isolated from UTI.

Patients and Methods: This cross-sectional study was conducted on 3126 samples. Urine specimens were cultured on Eosin Methylene Blue (EBM) and blood agar. The disk diffusion standard method (Kirby Bauer) was used to test the susceptibility of the drug on MullerHinton agar plates and results were reviewed based on Clinical and Laboratory Standards Institute (CLSI) criteria. The reviewing of ESBL-producing uropathogens was carried out using Combined Disk Test (CDT) by using cefotaxime (CTX; 30 µg) and cefotaximeclavulanic acid (CTX; 30 µg /CA:10 µg) disks and CLSI protocol.

Results: Out of 291 E. coli isolates, 108 (37.11%) are ESBL-producer and 183 (62.89%) are non–ESBL-producer. Among ESBL-producing E. coli, the highest antibiotic resistance was observed with cefotaxime (100%), amoxicillin (97.22%) and piperacillin (96.3%) and the highest antibiotic sensitivity was observed with meropenem (93.5%), nitrofurantoin (81.48%) and gentamicin (55.56%).

Conclusion: We recommended that cephalosporins, penicillins and cotrimoxazole are not suggested in the treatment of ESBL-producing E. coli. On the other hand, carbapenems as a first line and aminoglycosides as the next step in the treatment of ESBL-producing E. coli are recommended. 


Implication for health policy/practice/research/medical education:

Knowing the prevalence and antibiotic resistance pattern of extended spectrum beta lactamase producing Escherichia coli as the most common urinary tract infection pathogen, in addition to alert to health system policymakers about increasing antibiotics resistance, helps therapists to prescribe appropriate antibiotics to treat them.

Please cite this paper as: Rajabnia M, Forghani MS, Hasani S, Bahadoram M, Mohammadi, Barahman M. Prevalence and antibiotic resistance pattern of extended spectrum beta lactamase producing Escherichia coli isolated from urinary tract infection. J Renal Inj Prev. 2019;8(2):78-81. DOI: 10.15171/jrip.2019.15.

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